Pi-Sunyer Xavier
Columbia University College of Physicians and Surgeons, P&S PO Box 30 DOM/NYORC, 630 West 168 Street, New York, NY 10032, , ,
Curr Nutr Rep. 2014 Dec;3(4):387-391. doi: 10.1007/s13668-014-0099-x.
The LookAhead trial was a randomized controlled trial comparing an Intensive Lifestyle Intervention (ILI) to a Diabetes Support and Education (DSE) in overweight and obese type 2 diabetes patients to track the development of cardiovascular disease over time. The triaI intervention was stopped for futility after a median follow-up of 9.6 years. While there was a differential effect on weight loss and fitness between the two groups, there was no effect on cardiovascular outcomes. Cardiovascular events were less than half the projected rate per year in the DSE group: thus there was a very low over-all rate of events in both groups. There were many other health benefits of ILI, including improved biomarkers of glucose and lipid control, less sleep apnea, lower liver fat, less depression, improved insulin sensitivity, less urinary incontinence, less kidney disease, reduced need of diabetes medications, maintenance of physical mobility, improved quality of life and lower costs.
前瞻性试验是一项随机对照试验，在超重和肥胖的2型糖尿病患者中比较强化生活方式干预（ILI）与糖尿病支持与教育（DSE），以追踪心血管疾病随时间的发展情况。在中位随访9.6年后，该试验干预因无效而停止。虽然两组在体重减轻和健康状况方面存在差异，但对心血管结局没有影响。DSE组的心血管事件少于每年预期发生率的一半：因此两组的总体事件发生率都非常低。ILI还有许多其他健康益处，包括改善血糖和血脂控制的生物标志物、减少睡眠呼吸暂停、降低肝脏脂肪、减轻抑郁、提高胰岛素敏感性、减少尿失禁、减少肾脏疾病、减少糖尿病药物需求、维持身体活动能力、提高生活质量和降低成本。
